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https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#1
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28335823/the-forge-ahead-clinical-readiness-consultation-tool-a-validated-tool-to-assess-clinical-readiness-for-chronic-disease-care-mobilization-in-canada-s-first-nations
#2
Mariam Naqshbandi Hayward, Selam Mequanint, Jann Paquette-Warren, Ross Bailie, Alexandra Chirila, Roland Dyck, Michael Green, Anthony Hanley, Jordan Tompkins, Stewart Harris
BACKGROUND: Given the astounding rates of diabetes and related complications, and the barriers to providing care present in Indigenous communities in Canada, intervention strategies that take into account contextual factors such as readiness to mobilize are needed to maximize improvements and increase the likelihood of success and sustainment. As part of the national FORGE AHEAD Program, we sought to develop, test and validate a clinical readiness consultation tool aimed at assessing the readiness of clinical teams working on-reserve in First Nations communities to participate in quality improvement (QI) to enhance diabetes care in Canada...
March 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28330414/male-subfertility-as-a-chronic-illness-the-role-of-adaptive-challenges
#3
Eleanor L Stevenson, Kevin R McEleny
Male factor infertility (MFI) is extremely common, often with several associated chronic health conditions. Because a man's fertility assessment may be their first contact with health services, the health care team has a responsibility to act as male health advocates to ensure comprehensive care. The diagnosis of subfertility allows a broader view of these men as patients with a chronic illness who have complex health needs. Because of the associated complexity of care following evaluation, there needs to be new approach in how men affected by MFI should be managed long term...
March 22, 2017: Human Fertility: Journal of the British Fertility Society
https://www.readbyqxmd.com/read/28329305/association-between-spousal-suicide-and-mental-physical-and-social-health-outcomes-a-longitudinal-and-nationwide-register-based-study
#4
Annette Erlangsen, Bo Runeson, James M Bolton, Holly C Wilcox, Julie L Forman, Jesper Krogh, M Katherine Shear, Merete Nordentoft, Yeates Conwell
Importance: Bereavement after spousal suicide has been linked to mental disorders; however, a comprehensive assessment of the effect of spousal suicide is needed. Objective: To determine whether bereavement after spousal suicide was linked to an excessive risk of mental, physical, and social health outcomes when compared with the general population and spouses bereaved by other manners. Design, Setting, and Participants: This nationwide, register-based cohort study conducted in Denmark of 6...
March 22, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28327136/perceptions-of-interprofessional-collaboration-of-general-practitioners-and-community-pharmacists-a-qualitative-study
#5
Christin Löffler, Carolin Koudmani, Femke Böhmer, Susanne D Paschka, Jennifer Höck, Eva Drewelow, Martin Stremme, Bernd Stahlhacke, Attila Altiner
BACKGROUND: Despite numerous evidences for the positive effect of community pharmacists on health care, interprofessional collaboration of pharmacists and general practitioners is very often limited. Though highly trained, pharmacists remain an underutilised resource in primary health care in most western countries. This qualitative study aims at investigating pharmacists' and general practitioners' views on barriers to interprofessional collaboration in the German health care system...
March 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28326901/continuity-of-care-to-prevent-readmissions-for-patients-with-chronic-obstructive-pulmonary-disease-a-systematic-review-and-meta-analysis
#6
Fen Yang, Zhen-Fang Xiong, Chongming Yang, Lin Li, Guiyuan Qiao, Yuncui Wang, Taoyun Zheng, Huijuan He, Hui Hu
Readmissions of patients with chronic obstructive pulmonary disease (COPD) to hospitals cast a heavy burden to health care systems. This meta-analysis was aimed to assess the efficacy of continuity of care as interventions, which reduced readmission and mortality rates of such patients. PubMed, Cochrane Library and Embase were searched for articles published before July 2015. A total of 31 reports with randomized controlled trials (RCTs) were finally included in this meta-analysis. The results showed that health education reduced all-cause readmission at 3 months...
April 2017: COPD
https://www.readbyqxmd.com/read/28324286/prolymphocytic-leukemia-new-insights-in-diagnosis-and-in-treatment
#7
REVIEW
Aude Collignon, Anne Wanquet, Elsa Maitre, Edouard Cornet, Xavier Troussard, Thérèse Aurran-Schleinitz
PURPOSE OF REVIEW: We aimed to produce a comprehensive update on clinical and biological data regarding two rare lymphoid neoplasms, B and T prolymphocytic leukemias, and assess therapeutic management in the light of new molecular insights and the advent of targeted therapies. RECENT FINDINGS: B cell prolymphocytic leukemia (B-PLL) diagnosis remains challenging in the absence of clear immunophenotypic or cytogenetic signature and overlap with mantle cell lymphoma...
April 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28321324/choosing-wisely-the-canadian-society-of-nephrology-s-list-of-5-items-physicians-and-patients-should-question
#8
Emilie Chan, Brenda Hemmelgarn, Scott Klarenbach, Braden Manns, Reem Mustafa, Gihad Nesrallah, Rory McQuillan
PURPOSE OF REVIEW: The purpose of this review is to contribute to the Choosing Wisely Canada campaign and develop a list of 5 items for nephrology health care professionals and patients to re-evaluate based on evidence that they are overused or misused. SOURCES OF INFORMATION: A working group was formed from the Canadian Society of Nephrology (CSN) Clinical Practice Guidelines Committee. This working group sequentially used a multistage Delphi method, a survey of CSN members, a modified Delphi process, and a comprehensive literature review to determine 10 candidate items representing potentially ineffective care in nephrology...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28318846/effectiveness-of-disease-specific-self-management-education-on-health-outcomes-in-patients-with-chronic-obstructive-pulmonary-disease-an-updated-systematic-review-and-meta-analysis
#9
REVIEW
Tao Wang, Jing-Yu Tan, Lily Dongxia Xiao, Renli Deng
OBJECTIVES: To update a previously published systematic review on the effectiveness of self-management education (SME) for patients with chronic obstructive pulmonary disease (COPD). METHODS: Electronic databases were accessed (from inception to July 2016) to find relevant randomized controlled trials. Studies that compared SME with routine methods of care in COPD patients were retrieved. Both data synthesis and descriptive analysis were used for outcome assessment (e...
March 1, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28317571/recent-recommendations-for-management-of-human-immunodeficiency-virus-positive-patients
#10
REVIEW
Miriam R Robbins
Human immunodeficiency virus (HIV) infection has become a chronic condition. HIV is not a valid reason to deny, delay, or withhold dental treatment. There are no absolute contraindications and few complications associated with comprehensive oral health care treatment delivered in an outpatient setting for asymptomatic HIV-infected patients and clinically stable patients with AIDS. Consultation with the patient's medical provider and modifications in the delivery of dental treatment may be necessary when treating patients with advanced HIV disease or other comorbid conditions...
April 2017: Dental Clinics of North America
https://www.readbyqxmd.com/read/28295781/spiritual-well-being-of-italian-advanced-cancer-patients-in-the-home-palliative-care-setting
#11
A A Martoni, S Varani, B Peghetti, D Roganti, E Volpicella, R Pannuti, F Pannuti
This study evaluates the spiritual well-being (SpWB) in very advanced cancer patients assisted by the home palliative care program of ANT Foundation, a no-profit Italian organisation. SpWB was assessed by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp12), including Meaning, Peace, and Faith subscales. The quality-of-life (QoL) was evaluated by using the Functional Assessment of Cancer Therapy-General scale. Questionnaires were distributed to 1,055 patients and 683 were compiled and evaluable for analysis...
March 14, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28295304/tension-type-headache-the-normal-and-most-prevalent-headache
#12
Rigmor Højland Jensen
PREMISE: Tension-type headache (TTH) is the most prevalent form of primary headache in the general population but paradoxically the least studied headache. PROBLEM: In this article, the epidemiology and diagnostic challenges of TTH are presented and discussed. The typical features and differential diagnosis of TTH are highlighted and the situations more likely to raise doubts are discussed. POTENTIAL SOLUTION: A structured approach to the patient and a better comprehension of the very frequent coexistence of migraine and medication overuse headache in the clinical population are emphasized...
March 13, 2017: Headache
https://www.readbyqxmd.com/read/28295249/development-and-validation-of-the-modified-patient-centered-medical-home-assessment-for-the-comprehensive-primary-care-initiative
#13
Dmitriy Poznyak, Deborah N Peikes, Breanna A Wakar, Randall S Brown, Robert J Reid
OBJECTIVE: To describe the modified Patient-Centered Medical Home Assessment (M-PCMH-A) survey module developed to track primary care practices' care delivery approaches over time, assess whether its underlying factor structure is reliable, and produce factor scores that provide a more reliable summary measure of the practice's care delivery than would a simple average of question responses. DATA SOURCES/STUDY SETTING: Survey data collected from diverse practices participating in the Comprehensive Primary Care (CPC) initiative in 2012 (n = 497) and 2014 (n = 493) and matched comparison practices in 2014 (n = 423)...
March 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28280406/development-and-implementation-of-a-registry-of-patients-attending-multidisciplinary-pain-treatment-clinics-the-quebec-pain-registry
#14
M Choinière, M A Ware, M G Pagé, A Lacasse, H Lanctôt, N Beaudet, A Boulanger, P Bourgault, C Cloutier, L Coupal, Y De Koninck, D Dion, P Dolbec, L Germain, V Martin, P Sarret, Y Shir, M-C Taillefer, B Tousignant, A Trépanier, R Truchon
The Quebec Pain Registry (QPR) is a large research database of patients suffering from various chronic pain (CP) syndromes who were referred to one of five tertiary care centres in the province of Quebec (Canada). Patients were monitored using common demographics, identical clinical descriptors, and uniform validated outcomes. This paper describes the development, implementation, and research potential of the QPR. Between 2008 and 2013, 6902 patients were enrolled in the QPR, and data were collected prior to their first visit at the pain clinic and six months later...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28279048/-understanding-and-treatment-strategy-for-disc-displacement-of-temporomandibular-disorders
#15
X C Ma
Understanding and treatment strategy for disc displacement of temporomandibular disorders (TMD) were discussed in the present review. It has been strongly recommended by the author that the treatment strategy for disc displacement, one subtype of TMD, should be mainly the reversible conservative treatment methods. The most important goal of treatment for disc displacement is to recover the mobility and function of the joint in order to improve the quality of the patient's life. Comprehensive assessments both from somatic and psychological aspects for each TMD patient are necessary, especially for the patients with chronic pain...
March 9, 2017: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
https://www.readbyqxmd.com/read/28270811/animal-models-of-leptospirosis-of-mice-and-hamsters
#16
REVIEW
Maria Gomes-Solecki, Ignacio Santecchia, Catherine Werts
Pathogenic Leptospira sp. are spirochetal bacteria responsible for leptospirosis, an emerging worldwide zoonosis. These spirochetes are very successful pathogens that infect a wide range of hosts such as fish, reptiles, birds, marsupials, and mammals. Transmission occurs when chronically infected animals excrete live bacteria in their urine, contaminating the environment. Leptospira sp. enter their hosts through damaged skin and mucosa. Chronically infected rats and mice are asymptomatic and are considered as important reservoirs of the disease...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28270122/implementation-of-integrated-geriatric-care-at-a-german-hospital-a-case-study-to-understand-when-and-why-beneficial-outcomes-can-be-achieved
#17
Loraine Busetto, Jörn Kiselev, Katrien Ger Luijkx, Elisabeth Steinhagen-Thiessen, Hubertus Johannes Maria Vrijhoef
BACKGROUND: Many health systems have implemented integrated care as an alternative approach to health care delivery that is more appropriate for patients with complex, long-term needs. The objective of this article was to analyse the implementation of integrated care at a German geriatric hospital and explore whether the use of a "context-mechanisms-outcomes"-based model provides insights into when and why beneficial outcomes can be achieved. METHODS: We conducted 15 semi-structured interviews with health professionals employed at the hospital...
March 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28258498/mortality-risk-among-screened-subjects-of-the-specific-health-check-and-guidance-program-in-japan-2008-2012
#18
Kunitoshi Iseki, Koichi Asahi, Kunihiro Yamagata, Shouichi Fujimoto, Kazuhiko Tsuruya, Ichiei Narita, Tsuneo Konta, Masato Kasahara, Yugo Shibagaki, Hisako Yoshida, Toshiki Moriyama, Masahide Kondo, Chiho Iseki, Tsuyoshi Watanabe
BACKGROUND: In Japan, the Specific Health Check and Guidance (Tokutei-Kenshin) has started in 2008. However, the relationship between the baseline characteristics and mortality has not been examined. METHODS: Subjects were those who participated at the 2008 Tokutei-Kenshin in six districts with baseline data of serum creatinine. Using National database of death certificate from 2008 to 2012, we identified those who might have died and confirmed further with the collaborations of the regional National Health Insurance agency and public health nurses...
March 3, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28253839/effectiveness-of-integrated-care-on-delaying-progression-of-stage-3-4-chronic-kidney-disease-in-rural-communities-of-thailand-escort-study-a-cluster-randomized-controlled-trial
#19
Teerayuth Jiamjariyapon, Atiporn Ingsathit, Krit Pongpirul, Kotcharat Vipattawat, Suphattra Kanchanakorn, Akhathai Saetie, Duangjit Kanistanon, Patimaporn Wongprompitak, Vinai Leesmidt, Watcharapong Watcharasaksilp, Wei Wang, Anil K Chandraker, Kriang Tungsanga
BACKGROUND: In developing countries, renal specialists are scarce and physician-to-patient contact time is limited. While conventional hospital-based, physician-oriented approach has been the main focus of chronic kidney disease (CKD) care, a comprehensive multidisciplinary health care program (Integrated CKD Care) has been introduced as an alternate intervention to delay CKD progression in a community population. The main objective is to assess effectiveness of Integrated CKD Care in delaying CKD progression...
March 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28251627/clinicians-perceptions-of-women-s-experiences-of-endometriosis-and-of-psychosocial-care-for-endometriosis
#20
Kate Young, Jane Fisher, Maggie Kirkman
BACKGROUND: Endometriosis is a complex, chronic condition with known psychological and social implications for women. Little is known about clinicians' perceptions of the psychosocial aspects of endometriosis and associated care. AIM: To describe clinicians' perceptions of women's experiences of living with endometriosis and of the provision of psychosocial care for endometriosis. MATERIALS AND METHODS: A qualitative approach was taken using semi-structured interviews with eight gynaecologists and four general practitioners who provide care to women with endometriosis in Victoria, conducted by telephone and in person from June to December 2014...
February 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
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